Why Enhanced Premium Tax Credits Should Be Made Permanent - Families USA Skip to Main Content

Why Enhanced Premium Tax Credits Should Be Made Permanent

Enhanced tax credits help make health insurance more affordable for individuals and families buying plans through the Affordable Care Act (ACA) marketplaces, including self-employed and gig workers. Created through the American Rescue Plan Act (ARPA) and extended through the Inflation Reduction Act (IRA), they significantly combat high health care costs and increase families’ access to affordability assistance. Since their implementation, the enhanced tax credits have helped reduce the uninsured rates, especially among Black and Latino individuals and lower income families, leading to record marketplace enrollment numbers.

Unfortunately, they expire at the end of 2025 unless Congress takes immediate action to help families avoid high health care costs by voting to make the enhanced tax credits permanent. If they don’t, premiums will increase for nearly all marketplace enrollees, and millions of people could lose their health insurance — reversing the health coverage gains over the last few years.

Families USA is a leading health care advocacy organization urging Congress to make them permanent. This fact sheet offers resources from Families USA and other organizations to help advocates and others interested in ensuring that millions don’t lose coverage and face high health care costs and premiums because Congress fails to act.

To learn more, view general and state-specific fact sheets about premium tax credit enhancements in ACA marketplaces.

State-by-state maps of people losing coverage by income level, age, race and ethnicity.
Source: Urban Institute

  • More than 70 organizations call on Congress to extend enhanced premium tax credits to keep health care affordable for millions of Americans.
    Source: Families USA
  • The National Association of Insurance Commissioners (NAIC) supports extending enhanced premium tax credits, and urges a decision by the end of 2024.
    Source: NAIC
  • Marketplace Enrollees Speak Out: People Fear Higher Costs if Congress Does Not Act
    Source: CBPP
  • 2.7 million small businesses and self-employed workers claimed the tax credit in 2022.
    Source: US Treasury Department
  • How Enhanced Premium Tax Credits for Affordable Health Care Empower Self-Employed Americans.
    Source: Center for American Progress
  • Understanding how the enhanced premium tax credits impact consumers.
    Source: State Marketplace Network 
  • State and congressional district data about the number of people who receive tax credits and the average annual premium increases they’d experience if enhancements expire.
    Source: Keep Americans Covered
  • Review the “health care savings” of this review of Congressional Districts. 
    Source: Regional Leadership Council 
  • This interactive “2024 Affordable Care Act Marketplace Plan Selections by Congressional District” includes data for the federally facilitated marketplace, Washington, DC, and Vermont. 
    Source: Center for American Progress (CAP) 

Robert Wood Johnson Foundation (RWJF) finds that in the leading farm states, a significant share of residents enroll in Medicaid and in the marketplace. In farm states, about half of marketplace enrollees are rural residents. Premium tax credits reduced marketplace enrollees’ premiums by an average of $506/month in farm states.
Source: RWJF

  • More people would become uninsured and seek uncompensated care. Hospitals and providers would take a hit, particularly in the South, rural communities, and in states that have not expanded Medicaid.
    Source: Urban Institute
  • This brief “Who benefits from enhanced premium tax credits in the marketplace” estimates 7.2 million more people will receive subsidized coverage as a result of premium tax credit enhancements, and 4 million fewer people will be uninsured.
    Source: Urban Institute  
  • Data by age, income, and for Blacks and Latinos. 
    Source: Center for Budget and Policy Priorities (CBPP)  
  • Enhanced premium tax credits cut premium payments by 44% on average, and helped more low-income enrollees enroll in plans with reduced deductibles. Premiums would double in 12 states for subsidized enrollees if enhanced premiums expire.
    Source: KFF
  • Find out how much ACA premium costs could increase in your state or congressional district using this interactive map.
    Source: KFF
  • 5.1 million ages 55–64 enrolled in Marketplace coverage in 2024 and more will do so as Medicaid unwinding continues. Uninsured rates for older adults have dropped dramatically since Affordable Care Act (ACA) implementation. 
    Source: AARP 
  • Without enhanced premium tax credits, a 60-year-old earning $60,251 would pay almost 20% of his or her income for an average marketplace plan.
    Source: Urban Institute
  • If enhanced credits expire, many 50-year-olds will see their silver plan premiums increase by 53%, and in some places, they will increase by 75%.
    Source: RWJF
    Map by zip code

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